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Das Obturator-externus-Impingement nach Hüftprothesenimplantation

Obturator externus impingement after total hip replacement

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Zusammenfassung

Der schmerzhafte Hüftgelenksersatz stellt nach Ausschluss von häufigen Ursachen meist eine diagnostische Herausforderung dar. Eine der seltenen Ursachen sind muskuläre Impingementsyndrome, welche bisher fast ausschließlich nur für den Iliopsoasmuskel beschrieben worden sind. Da hüftgelenknah verschiedene Muskelinsertionen vorliegen, ist prinzipiell ein Impingement anderer Muskeln am Implantat ebenfalls vorstellbar. Wir berichten über den Fall eines schmerzhaften M.-obturator-externus-Impingements an der Pfannenkomponente. Mit Hilfe der MRT konnte ein pathologischer Muskel-Pfannen-Kontakt des M. obturator externus am kaudalen Pfannenrand dargestellt und durch einen positiven Infiltrationstest bestätigt werden.

Abstract

A patient with a painful total hip replacement that is not obviously loose presents a diagnostic challenge. One of the rare causes is psoas impingement syndrome. Because there are several periarticular muscles, further muscle impingements are possible. We report on a case of painful obturator externus muscle impingement on the acetabular cup. On magnetic resonance imaging, a pathologic contact between the obturator externus muscle and the caudal rim of the cup was seen. A positive injection confirmed the pathologic contact.

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Müller, M., Perka, C. & Tohtz, S. Das Obturator-externus-Impingement nach Hüftprothesenimplantation. Orthopäde 38, 1113–1116 (2009). https://doi.org/10.1007/s00132-009-1469-8

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